title: Lemierre syndrome from a neck abscess due to methicillin-resistant Staphylococcus aureus.
abstract: Lemierre syndrome is characterized by acute septic thrombophlebitis of the internal jugular vein (IJV) that develops after an oropharyngeal infection, and can be complicated by septic emboli to lungs and other organs. The most frequent causative agent is Fusobacterium necrophorum, an anaerobic bacillus found in normal oropharyngeal flora. Staphylococcus aureus has emerged as a cause of Lemierre syndrome in the last decade. We report a case of a 24-year-old man who developed septic IJV thrombosis and necrotizing pneumonia due to S. aureus from an infected hematoma in the right sternocleidomastoid muscle. Antibiotics are the mainstay of therapy with few cases needing anticoagulation. A good outcome is dependent upon an awareness of the condition, a high index of suspicion, and prompt initiation of antibiotic therapy. Recognition of S. aureus as a cause of Lemierre syndrome can guide the choice of initial antibiotics to cover this virulent pathogen.
authors.affiliation: Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA. aagarwal@uams.edu
authors.forename: Agarwal
authors.initials: A
authors.lastname: Abhishek
authors.forename: Singla
authors.initials: S
authors.lastname: Sandeep
authors.forename: Pandey
authors.initials: P
authors.lastname: Tarun
mesh_terms: D000038:Abscess / Q000150:complications* / Q000382:microbiology; D005260:Female; D006801:Humans; D057831:Lemierre Syndrome / Q000000981:diagnostic imaging / Q000382:microbiology*; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D013203:Staphylococcal Infections / Q000150:complications*; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: Internal jugular vein thrombosis; Pulmonary emboli; Septic emboli; Staphylococcus aureus